Go to work on mental health

Ministry of Social Development (MSD)

Over 57,000 of Ministry of Social Development’s clients currently receive a benefit due to the impact their mental health condition has on their ability to work. Mental health conditions have accounted for 97% of the growth in health related benefits in the last 10 years, and this is part of an international trend.

People with mental health conditions often have poor employment outcomes. There are a number of barriers that prevent them from finding and keeping a job. We know that appropriate work, combined with the right support, is good for people’s mental health and people with mental health conditions can and want to work.

This opportunity is about improving employment outcomes for people with common mental health conditions so they can help themselves to be safe, strong, healthy and independent.

David’s experience

David had been in fulltime work and managing a mental health condition for over 10 years. However, two years ago he became unwell and lost his job. He is now getting a benefit.

The longer he is out of work, the more his mental health deteriorates. He lives alone and rarely speaks to his family. Not being in work increases his isolation.

David has a Work and Income case manager named Tracey, who has a comprehensive knowledge of David’s employment history. She refers him to a doctor and over two years David receives a variety of treatments with varying success. Tracey gets regular reports on David’s progress.

Recently, David has been responding well to a Cognitive Behavioural Therapy called Beating The Blues, and has been feeling much more optimistic about his future. He tells Tracey that he would like to return to the workforce.

Tracey has concerns about David’s ability to work. She only wants the best for her client, and knows David does not react well to the pressure of finding work. The last time she helped David to find a role, his employment was terminated within a fortnight. This triggered a series of events that affected David’s wellbeing, and nearly resulted in David losing his tenancy.

Tracey reviews the latest doctor’s report and, while it indicates steady improvement, it clearly recommends no sudden changes to David’s current situation for the fear of negatively impacting the progress he has made. She advises David not to look for work right now.

David feels like what he wants and what he feels capable of isn’t important.

Problems experienced

For clients:

Unconscious bias and stigma from employers, professionals and agencies

A lack of access to the right support and services at the right time

Low expectations of work ability by individuals and professionals including health professionals and case managers

The impact poor mental health has on the ability to work

How best to share personal information about the impact their mental health condition has on their ability to work

Loss of income, increasing the risk of poverty, poorer health and social exclusion

For government:

Impacts on the criminal justice system

Elevated health and welfare costs

Difficulties with referrals and case management systems

For employers:

Lack of knowledge about how to best support a staff member (new or existing) with a mental health condition

Stigma from co-workers that can result in discrimination and harassment

Concerns about elevated costs due to low motivation levels and absenteeism

Impact on the time taken to complete tasks, check work and provide additional supervision.

Why is this the right time?

Poor mental health affects one-fifth of the working age population at any one time and one in two people will have a period of poor mental health in their lifetime. The impact of poor mental health is a growing concern both here and internationally with direct and indirect impacts for individuals and wider society.

The New Zealand government has increased its focus on mental health across agencies especially the Prime Minister’s mental health initiatives. There are examples of good practice but MSD still needs to learn about what is effective in supporting clients with a mental health condition to find and stay in work. MSD cannot solve this problem on its own and needs new ideas and contributions from others to be successful.

If mental health is not well managed in the workplace it can increase the likelihood of sickness absence and reduced productivity. A 2009 Southern Cross report estimated the total cost to New Zealand employers from poor health of employees to be $2 billion and two thirds of the costs was a result of presenteeism.

The OECD has estimated the direct and indirect costs of poor mental health can exceed four percent of Gross Domestic Product. Poor mental health can cost national economies several billion dollars, both in terms of expenditures incurred and loss of productivity.

What does success look like

A successful solution would improve employment outcomes, increase education levels and result in overall improved socio-economic and health outcomes. In turn, there would be reduced costs to government agencies due to decreases in costs in the health, welfare and justice systems.

MSD would also understand more about the clients we work with, which would help us to better design future services in order to be more cost effective.

There would be benefits to the economy and society. Businesses that employ people with common mental health conditions would also benefit by supporting more diverse workplaces which we know are good for business, e.g. obtaining new skills, valuable perspectives and improved customer relations.

There will also be a reduction in costs due to employees maintaining wellness at work, which would lower absenteeism, whilst increasing productivity.

A solution to this problem would:

Be mindful of current legislative frameworks, e.g. Social Security Act 1964, Privacy Act 1993, and the Human Rights Act 1993.